[Factors related to non-participation in a breast cancer early detection program]

To determine the causes of non-participation in a breast cancer early detection program for women in the northern area of Almería (Spain).

We performed a case-control study. A sample of women included in a breast cancer early detection program between October 2002 and February 2004 was chosen. Participants were interviewed about family, sociodemographic and program-related variables (knowledge, accessibility, attitudes), family and personal history, and health status. Possible differences among women who attended the program and those who did not were analyzed through bivariate analysis and multivariate logistic regression. Odds ratio (OR) and 95% confidence interval (95%CI) were calculated.

A total of 720 questionnaires were completed (350 cases and 370 controls) and 291 women (40.4% of the sample) were replaced. The variables found to be independently associated with non-participation in the program were as follows: not receiving a letter (OR=11.2; 95%CI: 4.6-26.9), undergoing mammography outside the program (OR=4.4; 95%CI: 2.8-6.9), not having illnesses requiring medical examinations (OR=2; 95%CI: 1.3-3), and expressing fear of the result of mammography (OR=1.8; 95%CI: 1.2-2.6).

Women who did not receive a letter or who underwent mammography outside the program had a greater risk of not attending the program, hence the need to improve the quality of the database. Awareness of the program should be increased among women and health education should be provided to women fearing the outcome.